| NPI | 1639147077 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: DC MD035783) | 
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: OH 35. 065870) | 
| Enumeration Date | 2006-03-10 | 
| Last Update Date | 2007-07-08 |