| NPI | 1154818029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS19389) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 58030233) |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2022-12-19 |