| NPI | 1285153635 |
|---|---|
| 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: MA 273321) |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2018-11-22 |