| NPI | 1467856054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD203332) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 85874) |
| 207R00000X Internal Medicine (Licence: MI 4301117067) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-10-10 |
| Last Update Date | 2024-05-15 |