| NPI | 1588314587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 1588314587) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 1588314587) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-03-24 |
| Last Update Date | 2023-04-20 |