| NPI | 1598389850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MD12255000) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT221123) |
| Enumeration Date | 2020-06-02 |
| Last Update Date | 2024-09-23 |