| NPI | 1871892364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301098789) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.135957) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MI 4301098789) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-03-23 |
| Last Update Date | 2021-03-09 |