| NPI | 1417151572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2011017817) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 50823) |
| 207L00000X Anesthesiology (Licence: AZ 42658) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2024-02-09 |