| NPI | 1467742841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.126092) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 57.019659) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2020-12-03 |