| NPI | 1891142998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35150182) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101269211) |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2024-04-25 |