| NPI | 1174938237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 34.017991) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO DR.0060105) |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2026-03-03 |