| NPI | 1568614410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 41910) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.130383) |
| Enumeration Date | 2008-10-22 |
| Last Update Date | 2020-09-11 |