| NPI | 1265528269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 02281) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 34.013175) |
| 207L00000X Anesthesiology (Licence: GA 068688) | |
| 207L00000X Anesthesiology (Licence: WI 2901) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2025-07-17 |