| NPI | 1720353808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35131323) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 274059) |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2018-10-15 |