| NPI | 1457712366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS20245) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 34.015314) |
| 207L00000X Anesthesiology (Licence: KY 04774) | |
| Enumeration Date | 2016-03-19 |
| Last Update Date | 2025-07-31 |