| NPI | 1144754862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OT017982) |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2017-08-17 |