| NPI | 1538152772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: FL ME163857) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: OH 35-065743) |
| 207L00000X Anesthesiology (Licence: OH 35-065743) | |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2026-01-12 |