| NPI | 1750523643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A122814) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207L00000X Anesthesiology (Licence: PA MD446892) | |
| 207L00000X Anesthesiology (Licence: IL MT201401) | |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2013-05-10 |