| 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 |