| NPI | 1124461819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 068053) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: IL 125069783) |
| 207LC0200X Anesthesiology Critical Care Medicine (Licence: NY 292670) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-11 |
| Last Update Date | 2022-05-27 |