| NPI | 1417319732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX U3449) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036152495) |
| 207L00000X Anesthesiology (Licence: NY 305291) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2024-08-13 |