| NPI | 1922486471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2025019173) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.136357) |
| 207L00000X Anesthesiology (Licence: TN 63619) | |
| Enumeration Date | 2015-05-15 |
| Last Update Date | 2025-06-25 |