| NPI | 1114554698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 34.017895) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OS024218) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 34.017895) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA OS024218) | |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2025-07-18 |