| NPI | 1851566046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301102724) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.099473) |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2023-02-06 |