| NPI | 1861691776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 32489) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 57012163) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2014-04-11 |