| NPI | 1700873239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WV 21494) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35066380) |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2007-07-08 |