| NPI | 1487615209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 34004394) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY C4230) |
| 207L00000X Anesthesiology (Licence: MS 21422) | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2025-09-19 |