NPI | 1023544137 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME155991) |
Additional Taxonomies | 208600000X Surgery (Licence: SC LL40845) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-05-10 |
Last Update Date | 2023-02-13 |