| NPI | 1164657102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.121945) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 57.016835) |
| Enumeration Date | 2009-05-20 |
| Last Update Date | 2014-04-24 |