| NPI | 1639699903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.148952) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 287504) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2023-07-31 |