| NPI | 1578598777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NE 36736) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35-084668) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: OH 35-084668) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2014-04-09 |