| NPI | 1669811238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MT 80614) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME161939) |
| 207L00000X Anesthesiology (Licence: NY 295005) | |
| 207L00000X Anesthesiology (Licence: MA 270678) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2024-05-06 |