| NPI | 1235592452 |
|---|---|
| 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: MS 30327) |
| 207L00000X Anesthesiology (Licence: OK 33138) | |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2022-07-27 |