| NPI | 1528044260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35-055131G) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME61902) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2025-10-22 |