| NPI | 1457579203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 59192) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35087908) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2019-10-30 |