| NPI | 1790709590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 34-007659) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OS013774) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2020-10-19 |