| NPI | 1568433241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 68305) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35056058) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2017-11-22 |