| NPI | 1104021336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.127294) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD431904) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2019-12-10 |