| NPI | 1720076888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology Critical Care Medicine (Licence: OH 35087130) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35087130) |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2018-05-15 |