| NPI | 1619786753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.154784) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 75.000066) |
| Enumeration Date | 2025-01-03 |
| Last Update Date | 2025-10-10 |