| NPI | 1922482850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD468589) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 57.025744) |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2019-10-23 |