| NPI | 1376542696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35060742) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35060742) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2014-10-16 |