| NPI | 1215977400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301086007) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.136955) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2019-08-06 |