| NPI | 1497771406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35070490) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 74014) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2025-09-16 |