| NPI | 1033798566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A199279) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 1023716) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-04-02 |
| Last Update Date | 2025-07-18 |