| NPI | 1588620280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 44329) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35077335) |
| Enumeration Date | 2006-04-22 |
| Last Update Date | 2013-11-14 |