| NPI | 1598152720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.133813) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ZZ 104566) |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2018-05-14 |