| NPI | 1386428670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MN 33207) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.152658) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL TRN38982) | |
| Enumeration Date | 2023-08-21 |
| Last Update Date | 2025-04-28 |