| NPI | 1669465738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 30187) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35060501) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2010-06-15 |