| NPI | 1740248202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: PA MD067951L) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.08238) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 35.082380) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2017-09-12 |