| NPI | 1710913611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD172211) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: OR 8185) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2018-10-11 |