| NPI | 1497772941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 35.091060) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 120038) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MO 120038) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2016-01-04 |