| NPI | 1376511030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME101617) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.087255) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2008-07-15 |