| NPI | 1144780040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD484869) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD484869) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2025-04-08 |