| NPI | 1730175019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35054101) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: OH 35054101) |
| 207L00000X Anesthesiology (Licence: KY 27479) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35054101) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 27479) | |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2022-03-01 |