NPI | 1124252945 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 35.132316) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 271999) |
207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: KY 54289) | |
Enumeration Date | 2009-05-07 |
Last Update Date | 2021-03-01 |