| NPI | 1992025670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME121792) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35122169) |
| 207L00000X Anesthesiology (Licence: MI 4301102015) | |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2024-08-26 |