| NPI | 1003982240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35053045) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35053045) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2012-09-24 |