| NPI | 1629067509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.129658) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A101808) |
| 207L00000X Anesthesiology (Licence: WA MD61531803) | |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2026-09-08 |