| NPI | 1376937714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 206498) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101261095) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2026-08-17 |