| NPI | 1912993056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WV 13474) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35056625) |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2020-10-05 |