| NPI | 1295977635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 34.010155) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OS016971) |
| 207L00000X Anesthesiology (Licence: TX Q0711) | |
| 207L00000X Anesthesiology (Licence: CA 20A13044) | |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2016-05-10 |