| NPI | 1114459393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NJ 25ma11408000) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207L00000X Anesthesiology (Licence: NJ 25MA11408000) | |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2023-05-22 |