Here are the things that I would try and change:
- Get Despair on hit
- Hit 300 Dex
- Hit 155 Str to get lvl 20 Determination since you're losing a lot of phy damage reduction from not being there
- Move a couple of points around to get near 100% spell suppression
- Think about moving from Master Surgeon to Natures Boon?
Items to make changes:
- Swap boot craft to lighting + Cold resist and hit 19-20
- Buy one of these amulets and hit with 20 intrinsic catalyst. It will get you 155 strength and 300 dex.
https://www.pathofexile.com/trade/search/Sanctum/vg6KQe9iE
- On the above amulet I put +1 all chaos or 23%+ dot multi. The dot multi is 7% more damage so pick one of those if you can afford it.
- Curse on hit ring with life and enough fire resist to cap you.
https://www.pathofexile.com/trade/search/Sanctum/8rwa6B8hV
At this point you now have 23% to 30% more damage and you have enough strength to cap Determination which is worth another 18% phy damage reduction.
- Take out extra point in the Revenge of the Hunted cluster and the Circling Oblivion medium jewel to get Entrench cluster to almost cap out spell suppression
- Move from Master Surgeon to Nature's Boon ascendancy node
- Swap out Dizzying Divine life flask for a Sulphur flask with immunity to corrupted blood on it
- Swap out Rumi's for a Granite flask with at least 50% increased armour effect ( with a capped out determination it's better than Rumi's now)
The above will get you a more useful ascendancy node which will help keep all flasks up longer, nearly cap your spell suppression and better defense/damage because of the flask changes.