| NPI | 1821196833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35059363) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 33140-020) |
| 207L00000X Anesthesiology (Licence: GA 63685) | |
| 207L00000X Anesthesiology (Licence: IL 036-112958) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2021-11-23 |