| NPI | 1659547768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P7518) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 57.009786) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX P7518) | |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2014-02-26 |