| NPI | 1689645095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 34006234) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 39175) |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2007-07-08 |