| NPI | 1255828257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX V7705) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 57.027301) |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2025-11-26 |