| NPI | 1295916997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA09012700) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH BM9528324-R077) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 2011-00759) | |
| Enumeration Date | 2007-11-21 |
| Last Update Date | 2021-07-23 |