| NPI | 1396397097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD61407162) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.247299) |
| 207L00000X Anesthesiology (Licence: OH 35.144409) | |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2024-06-01 |