| NPI | 1891215026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 57.251067) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R-11029) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2021-06-28 |