NPI | 1447754452 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE 9658) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
171000000X Military Health Care Provider (Licence: VA 0101267531) | |
Enumeration Date | 2018-03-23 |
Last Update Date | 2023-06-15 |