| NPI | 1083602148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 30786) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35C.004365) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: DC 30786) | |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2026-09-16 |