NPI | 1780189191 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 71446) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207L00000X Anesthesiology (Licence: NJ 25MB11570700) | |
Enumeration Date | 2018-03-27 |
Last Update Date | 2025-02-19 |