| NPI | 1144413360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: KY 42648) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MD428373) |
| 207L00000X Anesthesiology (Licence: PA MD428373) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: KY 42648) | |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2014-09-04 |