| NPI | 1902876733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 227415) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NY 227414) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CO 48735) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO 48735) | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2021-03-04 |