| NPI | 1386887461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MB09306500) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OT012972) |
| 207L00000X Anesthesiology (Licence: PA OS016513) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT012972) | |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2022-09-12 |