| NPI | 1386011005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA OS022255) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207L00000X Anesthesiology (Licence: DE C2-0023817) | |
| Enumeration Date | 2015-08-28 |
| Last Update Date | 2026-07-16 |