| NPI | 1972688067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: FL ME118439) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 096944) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2022-03-09 |