| NPI | 1306189618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 35.131892) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A135222) |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2018-09-04 |