| NPI | 1437648417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301508937) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301114746) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301114746) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-05-06 |
| Last Update Date | 2024-12-22 |