| NPI | 1639190499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35.130894) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 234358) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2022-07-21 |