NPI | 1740604867 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: PA MD475576) |
Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 35.122857) |
207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: KY 49657) | |
Enumeration Date | 2014-02-10 |
Last Update Date | 2024-01-24 |