| NPI | 1023471430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 34.014516) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 58007485) |
| Enumeration Date | 2016-04-02 |
| Last Update Date | 2020-05-06 |