| NPI | 1124043799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WV 09848) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35037121R) |
| 207L00000X Anesthesiology (Licence: PA MD032829E) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2010-07-15 |