| NPI | 1790865160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: DC MD037907) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.088105) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2025-06-25 |