| NPI | 1184609638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX M1630) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 34-009510) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2015-11-01 |