| NPI | 1437394574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME150869) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 251705-1) |
| 207L00000X Anesthesiology (Licence: PA md438617) | |
| 207R00000X Internal Medicine (Licence: PA md438617) | |
| 207R00000X Internal Medicine (Licence: NY 251705-1) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2025-08-05 |