| NPI | 1558865824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.150090) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301503404) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2026-03-03 |