NPI | 1356683643 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.133626) |
Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35.133626) |
207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 35.133636) | |
Enumeration Date | 2013-03-25 |
Last Update Date | 2022-02-04 |