| NPI | 1689964942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MI 4301508317) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.134692) |
| 207L00000X Anesthesiology (Licence: FL TRN: 19585) | |
| 207L00000X Anesthesiology (Licence: FL ME130490) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2022-12-12 |