| NPI | 1508857392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.071782) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD00028209) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2018-10-16 |