| NPI | 1770757536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35094746) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036115753) |
| 207L00000X Anesthesiology (Licence: NY 248624) | |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2015-05-19 |