| NPI | 1427323096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2018019496) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 1068) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-03-15 |
| Last Update Date | 2021-02-01 |