| NPI | 1639438484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60751680) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CA A131062) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2022-07-21 |