| NPI | 1588662456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0050828) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 34007108) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2018-05-23 |