| NPI | 1376986265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: PA MD471399) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 280564) |
| 207L00000X Anesthesiology (Licence: PA MD471399) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2022-03-09 |