| NPI | 1609261098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LC0200X Anesthesiology Critical Care Medicine (Licence: MI 4301502167) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125.066871) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2020-07-24 |