| NPI | 1952573396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301097259) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 57.011401) |
| Enumeration Date | 2008-03-26 |
| Last Update Date | 2026-04-13 |