| NPI | 1780671206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WV 1189) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 34006578) |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2020-10-05 |