| NPI | 1831414630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MT MED-PHYS-LIC-35961) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NM MD2014-0168) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2020-03-12 |