| NPI | 1376542332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35055736) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 282523) |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2015-12-24 |