| NPI | 1922757897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 34.018514) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MB13031700) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207L00000X Anesthesiology (Licence: PA OS025550) | |
| Enumeration Date | 2022-03-19 |
| Last Update Date | 2026-07-06 |