| NPI | 1629022207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: OH 35.056976) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35-056976) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2021-03-18 |