| NPI | 1598976896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301090274) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 57007939) |
| 207L00000X Anesthesiology (Licence: KY C4693) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2025-10-28 |