| NPI | 1255659256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35128995) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: AL 31277) |
| Enumeration Date | 2010-05-14 |
| Last Update Date | 2019-07-03 |