| NPI | 1306885090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 58240) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35058128S) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2021-08-19 |