| NPI | 1730349572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA OP60344220) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 58.002432) |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2016-11-14 |