NPI | 1235573775 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 61912) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125.065454) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301102591) | |
Enumeration Date | 2013-04-27 |
Last Update Date | 2025-05-09 |