| NPI | 1245557735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 51076) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35 123530) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35 123530) | |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2022-08-25 |