| NPI | 1275527756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME75337) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35076224) |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2020-04-16 |