| NPI | 1851557698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301092378) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301092378) |
| 207L00000X Anesthesiology (Licence: AL 29826) | |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2015-09-14 |