| NPI | 1497250872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 93026) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: 64063) |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2022-09-09 |