| NPI | 1366466070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: OH 35-039301) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35-039301) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 35-039301) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2011-07-06 |