| NPI | 1043294416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35051637) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC MD23820) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2020-10-26 |