| NPI | 1366769739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA09429200) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT196583) |
| 207L00000X Anesthesiology (Licence: PA MT196583) | |
| Enumeration Date | 2010-04-26 |
| Last Update Date | 2023-12-01 |