| NPI | 1902048127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS11707) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 58.002835) |
| Enumeration Date | 2009-04-02 |
| Last Update Date | 2019-10-28 |