| NPI | 1891909222 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35087048)  | 
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine (Licence: OH 35087048)  | 
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: OH 35087048)  | |
| 207LH0002X Anesthesiology, Hospice and Palliative Medicine (Licence: OH 35087048)  | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35087048)  | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 35087048)  | |
| Enumeration Date | 2007-05-08 | 
| Last Update Date | 2010-08-25 |