| NPI | 1598820706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 35903790) |
| Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: CA 20A 10138) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2022-08-29 |