| NPI | 1790171577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.135304) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 66412-20) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2022-04-14 |