| NPI | 1063496552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 43854) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35086539) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2017-11-16 |