| NPI | 1518241538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 006627) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 58.004092) |
| Enumeration Date | 2011-10-10 |
| Last Update Date | 2015-07-27 |