| NPI | 1912092107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL OS13604) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 34 008818) |
| 207L00000X Anesthesiology (Licence: FL OS13604) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 34008818) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2019-08-15 |