| NPI | 1124260963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology Critical Care Medicine (Licence: NV 14982) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207LC0200X Anesthesiology Critical Care Medicine (Licence: FL ME 115022) | |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2014-05-22 |