| NPI | 1033672431 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35.150539) | 
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 59692) | 
| Enumeration Date | 2019-04-11 | 
| Last Update Date | 2024-06-24 |