| NPI | 1568955813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: OH 35.148557) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.245818) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2024-05-08 |