| NPI | 1780683656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35068550) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 77083) |
| 207L00000X Anesthesiology (Licence: MO 2021041427) | |
| 207L00000X Anesthesiology (Licence: MI 4301407542) | |
| 207L00000X Anesthesiology (Licence: IL 036076402) | |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2022-05-05 |