| NPI | 1760551444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35.090450) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: DC MD034906) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2018-06-13 |