| NPI | 1255545695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 54481) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 34.009283) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2022-06-08 |