| NPI | 1144664178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 50245) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY R3226) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-21 |
| Last Update Date | 2018-03-17 |