| NPI | 1073571469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: OH 35.067277) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.067277) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: OH 35.067277) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2015-12-30 |