| NPI | 1174725626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LA0401X Anesthesiology, Addiction Medicine (Licence: OH 35.091491) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 57008709) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2022-01-05 |