| NPI | 1053587683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.127062) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT188693) |
| Enumeration Date | 2008-05-04 |
| Last Update Date | 2015-10-06 |