| NPI | 1811332620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.133955) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301102489) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: OH 35.133955) | |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2020-09-15 |