| NPI | 1174082309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL OS20215) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207L00000X Anesthesiology (Licence: WA OP61388742) | |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2023-07-03 |