| NPI | 1033119607 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35068184) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35068184) |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2021-06-07 |