| NPI | 1821028242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35128865) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301072654) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2022-12-09 |