| NPI | 1265173280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 74602) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 1265173280) |
| 207L00000X Anesthesiology (Licence: GA 113815) | |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2026-08-14 |