| NPI | 1770597056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301079559) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.136932) |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2019-06-21 |