| NPI | 1417161209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD H72945) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0102202556) |
| 207L00000X Anesthesiology (Licence: VA 0102202556) | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2013-11-27 |