| NPI | 1093132250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 73293) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036.146056) |
| 207L00000X Anesthesiology (Licence: KY 49649) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2023-02-03 |