| NPI | 1780812347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 1663) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH NA) |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2013-06-17 |