| 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 |