| NPI | 1639157241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.094758) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 157615) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2010-06-02 |