| NPI | 1619082955 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: PA MD426383) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD426383) | 
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MD426383) | |
| Enumeration Date | 2006-08-19 | 
| Last Update Date | 2013-04-11 |