| NPI | 1700905064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.137305) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 63275-20) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2021-05-28 |