| NPI | 1356332381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: OH OH - 3167) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 3167) |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2010-12-23 |