| NPI | 1194714196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 64389) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35086107) |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2021-08-18 |