| NPI | 1669696167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 842985) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO DR.0053470) |
| 207L00000X Anesthesiology (Licence: OH 35.089188) | |
| 207L00000X Anesthesiology (Licence: ND 24217) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35.089188) | |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2026-06-02 |