| NPI | 1912925348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NM MD2018-0621) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2003009570) |
| 207L00000X Anesthesiology (Licence: OH 35.088638) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2023-07-10 |