| NPI | 1881056166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IL 036-167591) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH pending) |
| 207L00000X Anesthesiology (Licence: OH 35.131085) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2024-06-19 |