| NPI | 1376006296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD484633) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A184305) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2025-06-18 |