| NPI | 1952613127 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35126513) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35126513) | 
| Enumeration Date | 2010-07-05 | 
| Last Update Date | 2025-09-25 |