| NPI | 1912143231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LH0002X Anesthesiology, Hospice and Palliative Medicine (Licence: OH 35.125413) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35.125413) |
| 208000000X Pediatrics (Licence: OH 35.125413) | |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2018-06-14 |