| NPI | 1861564098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WV 17669) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.062056) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2011-09-22 |