| NPI | 1467654533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.097816) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME104412) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2017-05-30 |