| NPI | 1386428670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MN 33207) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL TRN38982) |
| 207L00000X Anesthesiology (Licence: OH 35.152658) | |
| Enumeration Date | 2023-08-21 |
| Last Update Date | 2026-06-12 |