| NPI | 1922097203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 12308) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA md449222) |
| 207L00000X Anesthesiology (Licence: OH 35086549) | |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2022-09-21 |