| NPI | 1134448087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: DC MD044783) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD450195) |
| 207L00000X Anesthesiology (Licence: PA MT197654) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT197654) | |
| Enumeration Date | 2010-05-18 |
| Last Update Date | 2017-11-30 |