| NPI | 1770556854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35 130081) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A109877) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2022-07-18 |