| NPI | 1851634018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD471587) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207L00000X Anesthesiology (Licence: NJ 25MA10084300) | |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2023-10-10 |