| NPI | 1326095506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301054713) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.141187) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2021-03-31 |