| NPI | 1023019437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35078316) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME133045) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2025-06-05 |