| NPI | 1174847891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology Critical Care Medicine (Licence: VA 0101260613) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101260613) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2019-03-07 |