| NPI | 1417911793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: TX M9515) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35063169M) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2022-12-06 |