| NPI | 1437788627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AL 42988) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AR E19148) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2026-02-04 |