| NPI | 1174729669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A123631) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2021-10-27 |