| NPI | 1902290729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S4663) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 34.013914) |
| Enumeration Date | 2015-03-19 |
| Last Update Date | 2022-07-27 |