| NPI | 1922374867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.127662) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: OH 35127662) |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2021-05-04 |