| NPI | 1265047450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 35.154246) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.154246) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: GA 12609) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35.154246) | |
| Enumeration Date | 2020-09-14 |
| Last Update Date | 2025-10-02 |