| NPI | 1386810554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VT 042.0014239) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NH 15036) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NH 15036) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2019-01-24 |