| NPI | 1649666751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 73077) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: OH 35.135014) |
| 207R00000X Internal Medicine (Licence: OH 35.135014) | |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2021-11-22 |