| NPI | 1811345119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A155314) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.028021) |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2021-12-17 |