| NPI | 1457665143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA 140298800) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.124088) |
| Enumeration Date | 2010-08-05 |
| Last Update Date | 2020-10-04 |