| NPI | 1053755579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS15407) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: FL OS15407) |
| 207LC0200X Anesthesiology Critical Care Medicine (Licence: KY TP978) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-26 |
| Last Update Date | 2024-01-09 |