| NPI | 1114501988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.155301) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 1.080494) |
| Enumeration Date | 2021-05-07 |
| Last Update Date | 2026-06-04 |