| NPI | 1265650410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 57.011667) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 52934) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2014-04-24 |