| NPI | 1174082259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.156299) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME161452) |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2026-06-03 |