| NPI | 1093004665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2015010082) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 04-43071) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2025-05-01 |