| NPI | 1477889335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301109813) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 81-000093) |
| Enumeration Date | 2009-10-28 |
| Last Update Date | 2016-08-15 |