| NPI | 1255574281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IL 336076605) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA 3277) |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: IA 3277) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: IL 336076605) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2012-05-01 |