| NPI | 1730178575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME147482) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.090308) |
| 207L00000X Anesthesiology (Licence: CO DR.0052097) | |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2021-06-21 |