| NPI | 1043339971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 251931-1) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY L-251931-1) |
| 207L00000X Anesthesiology (Licence: MI L 1229891) | |
| 207LC0200X Anesthesiology Critical Care Medicine (Licence: NY 251931) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301085208) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2024-05-03 |