| NPI | 1568166023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 57.254907) |
| 207L00000X Anesthesiology (Licence: OH 254907) | |
| Enumeration Date | 2023-03-29 |
| Last Update Date | 2024-04-04 |