| NPI | 1457088817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 35.152200) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.152200) |
| Enumeration Date | 2022-08-05 |
| Last Update Date | 2025-01-12 |