| NPI | 1659990737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.146646) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A194409) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A194409) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35.146646) | |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2025-08-22 |