| NPI | 1679571855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.050894) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IN 01057869) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2021-01-29 |