| NPI | 1376998500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 34.016187) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MB10835200) |
| 207L00000X Anesthesiology (Licence: OH 58.031891) | |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2022-11-16 |