| NPI | 1346770427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA OS021822) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MB11374600) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2024-06-04 |