| NPI | 1003298316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ND 15712) |
| Additional Taxonomies | 208D00000X General Practice (Licence: ND RL 13722) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11018737A) | |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2023-08-03 |