| NPI | 1104320209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: 64008) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL 154615) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 154615) | |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2022-06-02 |