| NPI | 1508418849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301510382) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.151447) |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2026-01-05 |