| NPI | 1669813218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: IA MD-45060) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA MD-45060) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5315060454) | |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2018-07-13 |