| NPI | 1346829926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CO DR.0077854) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 94238949082390890) |
| Enumeration Date | 2021-04-02 |
| Last Update Date | 2026-07-17 |