| NPI | 1467697060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.099887) |
| Additional Taxonomies | 208D00000X General Practice (Licence: GA 061913) |
| Enumeration Date | 2008-12-10 |
| Last Update Date | 2017-05-31 |