| NPI | 1174132724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: PA MT230223) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 20240113880) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2025-06-19 |