| NPI | 1043262090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 200200880) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 34-007693-C) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2012-07-27 |