| NPI | 1902827587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: OH 34-003296) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35-003296) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2015-04-28 |