| NPI | 1811919194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX M7227) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35-084765) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2023-05-24 |