| NPI | 1831142140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35-083891) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35-083891) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OK 32754) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2023-02-08 |