| NPI | 1841401130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35087622) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 57007234) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2019-11-19 |