| NPI | 1558111310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: KY 390200000X) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 00000000) |
| Enumeration Date | 2024-03-25 |
| Last Update Date | 2024-03-25 |