| NPI | 1417584095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.153410) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301511257) |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2025-07-29 |