| NPI | 1124282199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 34.011794) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL OS12287) |
| 207L00000X Anesthesiology (Licence: PA OS014646) | |
| 207L00000X Anesthesiology (Licence: KY C4331) | |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2025-08-07 |