| NPI | 1972599611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WV 14470) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35070054) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2022-08-29 |