| NPI | 1679076459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 24185) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NV 24185) |
| Enumeration Date | 2018-03-17 |
| Last Update Date | 2024-02-09 |