| NPI | 1841466547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2019-02619) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 57.010035) |
| Enumeration Date | 2008-05-02 |
| Last Update Date | 2024-09-18 |