| NPI | 1255402681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WV 13950) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.080574) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2011-10-06 |