| NPI | 1235314998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 43519) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 57.014040) |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2011-10-21 |