| NPI | 1942283676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD171659) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35084131P) |
| 207L00000X Anesthesiology (Licence: CA G88700) | |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2015-11-11 |