| NPI | 1699119990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 286948) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.152599) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35.152599) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 35.152599) | |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2025-02-20 |