| NPI | 1144573858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME127604) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD220447) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2024-07-08 |