| NPI | 1639610843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: GA 94994) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 65868) |
| 207L00000X Anesthesiology (Licence: MA 271345) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2023-06-06 |