| NPI | 1700885993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35050919) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: OH 35050919) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2014-11-27 |