| NPI | 1093942211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2014-02026) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 156622) |
| 207L00000X Anesthesiology (Licence: MA 255035) | |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2018-01-26 |