| NPI | 1487649836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: OH 35078344) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35078344M) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2011-03-09 |