| NPI | 1285070755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: PA MD476549) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA11590800) |
| Enumeration Date | 2013-05-10 |
| Last Update Date | 2024-05-22 |