| NPI | 1013128305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35096406) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 44938) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2018-09-13 |