| NPI | 1013969229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME165018) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.098308) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 35.098308) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2024-02-26 |