| NPI | 1083858740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD482905) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA08538600) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NJ 25MA08538600) | |
| 208000000X Pediatrics (Licence: NJ 25MA08538600) | |
| Enumeration Date | 2009-04-25 |
| Last Update Date | 2023-12-21 |