| NPI | 1437644226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 94674) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 010105) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2023-06-13 |