| NPI | 1093939522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 5854) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 260849) |
| 207L00000X Anesthesiology (Licence: OH 34.009324) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2022-05-16 |