| NPI | 1154349074 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: OH 35-081809)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35-081809)  | 
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 35-081809)  | |
| Enumeration Date | 2006-07-18 | 
| Last Update Date | 2011-07-05 |