| NPI | 1639737703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 34.016806) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101027197) |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2026-02-09 |