| NPI | 1891754016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2021-00225) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 87334) |
| 207L00000X Anesthesiology (Licence: CT 044340) | |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2024-09-20 |