| NPI | 1700827623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME133581) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35-081655) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2019-03-31 |