| NPI | 1972720431 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.097146) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL 30163) | 
| Enumeration Date | 2007-04-19 | 
| Last Update Date | 2018-10-12 |