| NPI | 1568998409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A179543) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101272674) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2022-12-13 |