| NPI | 1063496586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: OH 35.085482) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.085482) |
| 207L00000X Anesthesiology (Licence: OK 21937) | |
| 207LH0002X Anesthesiology Hospice and Palliative Medicine (Licence: OH 35.085482) | |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2024-08-29 |