| NPI | 1285678847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 40068) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35060464) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: SC 40068) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2017-04-05 |