| NPI | 1033397443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: LA MD.205494) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 57.012996) |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2013-03-01 |