| NPI | 1659734002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 62778) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125068144) |
| 207R00000X Internal Medicine (Licence: IL 125068144) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-03 |
| Last Update Date | 2021-05-05 |