| NPI | 1881645141 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: FL ME107713) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35048597) | 
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 35048597) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35048597) | |
| Enumeration Date | 2006-05-12 | 
| Last Update Date | 2012-02-16 |