| NPI | 1336108679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WV 1274) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 34.011311) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2025-08-20 |