| NPI | 1497955868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 34.010108) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 58-002355) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2013-10-14 |