| NPI | 1770826299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 51044) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 57.022765) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2024-03-25 |