| NPI | 1346236189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WV 15941) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35061294) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2021-11-02 |