| NPI | 1902292527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.139660) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS T-2922) |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2021-10-08 |