| NPI | 1174899363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME133456) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 129107) |
| Enumeration Date | 2012-04-01 |
| Last Update Date | 2018-08-29 |