| NPI | 1336883552 |
|---|---|
| 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: NM DO2026-0022) |
| Enumeration Date | 2022-04-25 |
| Last Update Date | 2026-03-31 |