| NPI | 1003047531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 116063) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 30135) |
| 207L00000X Anesthesiology (Licence: WA MD60681697) | |
| 207L00000X Anesthesiology (Licence: FL ME166160) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-07-31 |
| Last Update Date | 2024-05-08 |