| NPI | 1518664598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MA 5001471) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2023-02-10 |
| Last Update Date | 2024-05-04 |