| NPI | 1205940772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: PA MD020270E) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD020270E) |
| 208000000X Pediatrics (Licence: PA MD020270E) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MD020270E) | |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2014-08-26 |