| NPI | 1679529929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA OS012348) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WV 2156) |
| 207L00000X Anesthesiology (Licence: OH 34-008766) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2020-10-04 |