| NPI | 1730449257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MB10960600) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OS018783) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-05-17 |
| Last Update Date | 2025-01-07 |