| NPI | 1093057747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 287653) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA10784900) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 230269407) | |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2023-02-08 |