| NPI | 1215151741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.095859) |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine (Licence: OH 35.095859) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2020-05-18 |