| NPI | 1407437361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2022-02629) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC RTL21-0275) |
| Enumeration Date | 2021-04-20 |
| Last Update Date | 2022-10-01 |