| NPI | 1780630178 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OK 2402) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AR E-2672) | 
| 207L00000X Anesthesiology (Licence: OH 34-004298T) | |
| Enumeration Date | 2006-05-26 | 
| Last Update Date | 2010-09-07 |