| NPI | 1235518903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 65396) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 390200D00X) |
| Enumeration Date | 2015-05-27 |
| Last Update Date | 2019-05-14 |