| NPI | 1821212986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.089759) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2006-01607) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2007-08-01 |