| NPI | 1326667544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 00000000) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 00000000) |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2020-04-09 |