| NPI | 1457671901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2012-01211) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 164670) |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2014-05-27 |