| NPI | 1124010558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: OH 35075193) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.075193) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2020-06-08 |