| NPI | 1477931848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD61037109) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA ML60569410) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2020-11-23 |