| NPI | 1891282372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA11387300) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 320548) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2023-01-04 |