| NPI | 1528379849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0054294) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.123820) |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2022-05-13 |