| NPI | 1043576705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 274161) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NY 274161) | |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2025-02-04 |