| NPI | 1447650171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 274374) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 262266) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2018-08-03 |