| NPI | 1417903527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WV 22560) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35080819) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2012-06-27 |