| NPI | 1780682542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX 653628) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35062450) |
| 207LC0200X Anesthesiology Critical Care Medicine (Licence: OH 35062450) | |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2022-09-26 |