| NPI | 1316238694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME123185) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207L00000X Anesthesiology (Licence: IN 01091924A) | |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2024-02-09 |