| NPI | 1194083949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD61025358) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 54041) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2022-06-29 |