| NPI | 1114926391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: OH 35038578) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: OH 35038578) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2014-10-13 |