| NPI | 1194215145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 332281) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: AL 46370) | |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2025-11-04 |