| NPI | 1396857512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA OS006817L) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 34005476) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2017-03-02 |