| NPI | 1427554740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AK 181967) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207L00000X Anesthesiology (Licence: WI 72515-21) | |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2022-07-07 |