| NPI | 1295347706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA MD-50329) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: IA MD-50329) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 57.248641) | |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2025-03-31 |