| NPI | 1902841828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35048180W) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: OH 35048180) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2007-07-08 |