| NPI | 1033188727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.098167) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 043876) |
| 207L00000X Anesthesiology (Licence: TX N4190) | |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2013-01-03 |