| NPI | 1013546571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KS 05-51123) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO 0008155) |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2026-04-21 |