| NPI | 1447757083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA10887500) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD474332) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2023-12-02 |