| NPI | 1740717503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.155079) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 286824) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2025-12-30 |