| NPI | 1811562366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MT222438) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT222438) |
| Enumeration Date | 2021-05-26 |
| Last Update Date | 2025-05-30 |