| NPI | 1740568633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: HI MD-22140) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 57.019310) |
| 207L00000X Anesthesiology (Licence: MI 4301106859) | |
| 207L00000X Anesthesiology (Licence: TX R8775) | |
| Enumeration Date | 2011-07-27 |
| Last Update Date | 2022-03-06 |