| NPI | 1346578937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G57440) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35 . 051852) |
| Enumeration Date | 2009-11-19 |
| Last Update Date | 2009-11-19 |