| NPI | 1447570072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: OH 67-000220) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: GA 005928) |
| 367H00000X Anesthesiologist Assistant | |
| Enumeration Date | 2010-06-05 |
| Last Update Date | 2013-09-04 |