| NPI | 1780941294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA MD-43195) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA 43195) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2021-06-03 |