| NPI | 1740778026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX V2194) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.144631) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2024-07-17 |