| NPI | 1669098216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: 4351046182) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301511805) |
| Enumeration Date | 2020-06-19 |
| Last Update Date | 2024-05-22 |