| NPI | 1154548691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: SC 32827) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 57.010385) |
| 207L00000X Anesthesiology (Licence: SC 32827) | |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2015-04-09 |