| NPI | 1861886756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.136412) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35.136412) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 35.136412) | |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2022-02-04 |