| NPI | 1396360848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.154915) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301507357) |
| 207L00000X Anesthesiology (Licence: WI 84720) | |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2026-02-04 |