| NPI | 1699986646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 52190) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35-094897) |
| 207LC0200X Anesthesiology Critical Care Medicine (Licence: OH 35-094897) | |
| 207LC0200X Anesthesiology Critical Care Medicine (Licence: MN 52190) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-03 |