| NPI | 1285029769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X (Licence: OH 35.135300) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35.135300) |
| 207L00000X Anesthesiology (Licence: OH 35.135300) | |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2025-09-10 |