| NPI | 1558326827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA MD.202840) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35057477) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2010-03-03 |