| NPI | 1396865531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301087656) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301087656) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MI 4301087656) | |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2020-02-19 |