| NPI | 1700107398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NH 24552) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 258759) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2023-08-09 |