| NPI | 1427219443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: HI MD16918) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207L00000X Anesthesiology (Licence: OR MD157221) | |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2013-07-09 |