| NPI | 1881659985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 0055824) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 34008169) |
| 207L00000X Anesthesiology (Licence: NC 2014-00975) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 34008169) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2014-00975) | |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2016-01-12 |