NPI | 1396008629 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME157892) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 78897) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT201353) | |
Enumeration Date | 2012-06-21 |
Last Update Date | 2025-07-25 |