| NPI | 1477973501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 77609) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D85161) |
| 207L00000X Anesthesiology (Licence: VA 0101264514) | |
| 207L00000X Anesthesiology (Licence: OR MD211240) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2025-06-19 |