| NPI | 1417585423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A194390) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2024-10-08 |