| NPI | 1174529440 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD433055) | 
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: PA MD433055) | 
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: PA MD433055) | |
| Enumeration Date | 2005-06-22 | 
| Last Update Date | 2025-03-18 |