| NPI | 1457640773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 285537) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 285537) |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2023-07-06 |