| NPI | 1457715047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: TN 5305) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: IA DO-05342) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2023-03-21 |