| NPI | 1073612073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.099988) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 35753) |
| 207L00000X Anesthesiology (Licence: IN 01054965A) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2025-12-18 |