| NPI | 1760825483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D0082841) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: DC MTL001610) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-11 |
| Last Update Date | 2019-10-15 |