| NPI | 1609166719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA A134604) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A134604) |
| 207L00000X Anesthesiology (Licence: OH 57.019549) | |
| Enumeration Date | 2011-04-10 |
| Last Update Date | 2024-04-11 |