| NPI | 1750347050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 35.141602) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX K0876) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2023-10-13 |