| NPI | 1437328614 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 51443-20)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 57.009196)  | 
| Enumeration Date | 2008-02-21 | 
| Last Update Date | 2008-05-14 |