| NPI | 1003998303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: MO 2004030800) |
| Additional Taxonomies | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: OH 35C.001656) |
| 207L00000X Anesthesiology (Licence: SC 91915) | |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2025-01-25 |