| NPI | 1518354950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 34.014387) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: UT 12544521-1204) | |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2022-11-25 |