NPI | 1053804187 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101268681) |
Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101268681) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-06-13 |
Last Update Date | 2022-06-17 |