| NPI | 1447639976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 34.018136) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL DO.2015) |
| 207L00000X Anesthesiology (Licence: TX Bp10053070) | |
| Enumeration Date | 2015-05-29 |
| Last Update Date | 2025-09-17 |