| NPI | 1154304095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35146227) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 214356) |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2022-10-28 |