| NPI | 1659507184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 59061) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 14020) |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2024-04-10 |