| NPI | 1346681392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 201701562) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101278790) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-07-07 |
| Last Update Date | 2023-10-23 |