| NPI | 1164638144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS10123) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 58.001257 TRAINING C) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2007-10-16 |