| NPI | 1568844553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: OK 35537) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY R3795) |
| 207L00000X Anesthesiology (Licence: SC 82123) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2021-06-09 |