| NPI | 1194260836 |
|---|---|
| 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: CT 86204) |
| Enumeration Date | 2017-01-04 |
| Last Update Date | 2026-08-28 |