| NPI | 1801281720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: AR E-12965) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AR E-12965) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 35.132191) | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2020-08-22 |