| NPI | 1588617963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ME DO2862) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 58. 005960) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2019-07-11 |