| NPI | 1336256486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35051485P) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35051485) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2013-02-25 |