| NPI | 1063402287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 31144) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 62695) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2011-01-26 |