| NPI | 1215490727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.150381) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 280113) |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2024-09-24 |