| NPI | 1487188157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 35.148492) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX BP10059246) |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2024-07-15 |