| NPI | 1649568007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A124475) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA09339100) |
| 207L00000X Anesthesiology (Licence: NY 264670-1) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2017-09-14 |