| NPI | 1013955376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301072738) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.140959) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2021-03-09 |