| NPI | 1780144287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 011009) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY PENDING) |
| 207L00000X Anesthesiology (Licence: NY 324099) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2024-07-03 |