| NPI | 1154303303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 43852-020) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35084280J) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2020-11-25 |