| NPI | 1457047599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0116041852) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 57.255289) |
| Enumeration Date | 2023-04-12 |
| Last Update Date | 2026-06-30 |