| NPI | 1528385432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 63222) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.124367) |
| Enumeration Date | 2010-05-01 |
| Last Update Date | 2024-03-29 |