| NPI | 1659869006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A163530) |
| 207L00000X Anesthesiology (Licence: ME MD28263) | |
| 207L00000X Anesthesiology (Licence: CA A163530) | |
| 207R00000X Internal Medicine (Licence: ME MD28263) | |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2024-05-22 |