| NPI | 1083885982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME101013) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35-079679) |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2010-04-28 |