NPI | 1316330418 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D90952) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207L00000X Anesthesiology (Licence: NY 294229) | |
Enumeration Date | 2015-03-12 |
Last Update Date | 2021-03-17 |