| NPI | 1639153646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 25114-020) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.053347) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2020-12-28 |