| NPI | 1386381317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL MILL-J6NA0P) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC MILL-J6NA0P) |
| Enumeration Date | 2022-05-20 |
| Last Update Date | 2023-05-08 |