| NPI | 1639147077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| 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 |