| NPI | 1104034792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.093576) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 57010200) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2018-01-02 |