| NPI | 1386933497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 35.133184) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.133184) |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2018-05-01 |