| NPI | 1508063124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.098660) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL TRN # 11440) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2012-02-23 |