| NPI | 1093150674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.127386) |
| Additional Taxonomies | 2084N0600X (Licence: OH 35.127386) |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2018-12-13 |