| NPI | 1386272805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: PA MT231617) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101274028) |
| 208D00000X General Practice (Licence: VA 0101274028) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2024-05-31 |