| NPI | 1346203254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.061593) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2005-01332) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: FL ME137991) | |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2022-02-04 |