| NPI | 1831203397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: PA MD428208) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD418208) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD418208) | |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2023-06-01 |