| NPI | 1225327265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD464999) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: DE C1-0012338) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207L00000X Anesthesiology (Licence: NJ 25MA09701500) | |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2020-12-09 |