| NPI | 1952980047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4351053693) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125078824) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2024-07-09 |