| NPI | 1245506153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VT 042.0013609) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VT 060.0004066) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-03-25 |
| Last Update Date | 2016-09-08 |