| NPI | 1578822482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NM MD2022-0380) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD60690770) |
| 207L00000X Anesthesiology (Licence: MA 262469) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2023-07-11 |