| NPI | 1316478522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD474637) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 272625) |
| 207L00000X Anesthesiology (Licence: PA FR0455522) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2022-01-24 |