| NPI | 1174986434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MI 4351045824) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-03 |
| Last Update Date | 2022-03-28 |