| NPI | 1669683462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 5101015562) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 34.008340) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2008-08-12 |