| NPI | 1467958371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 314772) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036.174113) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-01 |
| Last Update Date | 2025-05-06 |