| NPI | 1396373189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 25012) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A190845) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-29 |
| Last Update Date | 2024-02-17 |