| NPI | 1962845065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 62417) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 57.022851) |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2018-03-17 |