| NPI | 1245659283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301502102) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.131703) |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2023-12-12 |