| NPI | 1144562729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: FL ME135345) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 57.023600) |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2018-08-14 |