| NPI | 1962962373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NJ 25MA12180400) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 326701) |
| 207L00000X Anesthesiology (Licence: NJ 25MA12180400) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NY 326701) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2024-07-12 |