| NPI | 1093033151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35-126995) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 269023) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35-126995) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 35-126995) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2023-06-29 |