NPI | 1306966627 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MI 4301087385) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301087385) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301087385) | |
Enumeration Date | 2007-03-30 |
Last Update Date | 2020-05-20 |