| NPI | 1750511275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: OR MD163127) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD452639) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2016-07-07 |