| NPI | 1932361664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35138023) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301092164) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2023-11-03 |