| NPI | 1285077859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2021-01959) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 51706) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: SC 51706) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2021-09-02 |