| NPI | 1063605772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35129884) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A120538) |
| Enumeration Date | 2007-08-26 |
| Last Update Date | 2018-10-15 |