| NPI | 1558340174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WV 19769) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35087051) |
| 207L00000X Anesthesiology (Licence: NC 200101192) | |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2007-07-08 |