| NPI | 1730382276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TN MD57600) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 050268) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: FL 15668) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2022-03-18 |