| NPI | 1962452110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35072330) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35072330) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 35072330) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2024-06-28 |