| NPI | 1861554081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: PA MD433839) |
| Additional Taxonomies | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: OH 35.093587) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2023-01-06 |