| NPI | 1003236225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 70654-20) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125065152) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-27 |
| Last Update Date | 2021-01-19 |