| NPI | 1134705502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 57.250473) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.152682) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2025-06-16 |