| NPI | 1225268204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 257197) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2013-12-17 |