| NPI | 1790740660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD444213) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35078688) |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2019-02-25 |