| NPI | 1285858639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME104807) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 57.010449) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2010-02-04 |