| NPI | 1174841365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D77648) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 234366590) |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2023-04-27 |