| NPI | 1841639002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 275064) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 57.029082) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MA 275064) | |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2023-06-01 |