| NPI | 1144313537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 39406) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35-123772) |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2019-05-01 |