| NPI | 1932148830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.122864) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 236129-1) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2021-07-30 |