| NPI | 1861771222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: DE C1-0010904) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 269636) |
| 207L00000X Anesthesiology (Licence: CA C-173510) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-08-16 |
| Last Update Date | 2024-07-11 |