| NPI | 1609336056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: OH 35.146157) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207L00000X Anesthesiology (Licence: OH 57.247363) | |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2022-08-02 |