| NPI | 1851669717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 34.010888) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 58.004204) |
| Enumeration Date | 2011-12-07 |
| Last Update Date | 2013-09-23 |