| NPI | 1851813489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA MD-47850) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125.073242) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301112146) | |
| Enumeration Date | 2017-07-14 |
| Last Update Date | 2021-07-10 |