| NPI | 1730506775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.133089) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 57.024254) |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2018-04-30 |