| NPI | 1407061385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.087726) |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine (Licence: OH 35.087726) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: OH 35.087726) | |
| 207LH0002X Anesthesiology, Hospice and Palliative Medicine (Licence: OH 35.087726) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35.087726) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 35.087726) | |
| Enumeration Date | 2007-05-13 |
| Last Update Date | 2010-08-19 |