| NPI | 1558523894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35120334) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC MMD.34482 MD) |
| 207L00000X Anesthesiology (Licence: OH 35120334) | |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2013-10-07 |