| NPI | 1104930981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35046748) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35 046748) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2013-06-24 |