| NPI | 1497962385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 03260) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: DC DO034292) |
| 207L00000X Anesthesiology (Licence: VA 0102201960) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: DC DO034292) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2010-07-27 |