| NPI | 1942439856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 47353) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ R71745) |
| 207L00000X Anesthesiology (Licence: FL 15506) | |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2015-06-30 |