| NPI | 1992265466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 05993) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 31.016628) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2025-12-15 |