| NPI | 1659808384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 20A19447) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207L00000X Anesthesiology (Licence: AZ 009046) | |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2023-12-04 |