| NPI | 1710159710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 062949) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 57.009459) |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2011-08-11 |