| NPI | 1215357967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.145212) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD467379) |
| Enumeration Date | 2014-04-21 |
| Last Update Date | 2022-06-13 |