| NPI | 1003801465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME114484) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35084421) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2013-05-10 |