| NPI | 1114338050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA10598100) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D85520) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2021-07-23 |