| NPI | 1154370633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: PA MD424798) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MD d59689) |
| 208000000X Pediatrics (Licence: PA MD424798) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2023-05-19 |