| NPI | 1215003355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35050545) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 21522) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 21522) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2016-11-02 |