| NPI | 1770075533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.149304) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD476020) |
| 207L00000X Anesthesiology (Licence: GA 010050) | |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2024-11-19 |