| NPI | 1003077157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.097161) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A120384) |
| 207L00000X Anesthesiology (Licence: OH 35097161) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A120384) | |
| Enumeration Date | 2008-06-21 |
| Last Update Date | 2023-03-24 |