| NPI | 1528267614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA md442183) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA mt190215) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2012-07-24 |