| NPI | 1457739914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 35.144005) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 279194) |
| Enumeration Date | 2015-05-15 |
| Last Update Date | 2023-02-15 |