| NPI | 1033671854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2024036733) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.148520) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35.148520) | |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2024-10-16 |