| NPI | 1659542660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 007292) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 58.002296) |
| 207L00000X Anesthesiology (Licence: VA 0102202710) | |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2019-12-16 |