| NPI | 1932189362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME65323) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: KY 50789) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 35.131901) | |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2023-02-14 |