| NPI | 1508864653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35049169) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: OH 350149169) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2012-03-08 |