| NPI | 1003885773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 043551) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.143944) |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2022-02-03 |