| NPI | 1699346205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116037525) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NM MD2024-0136) |
| Enumeration Date | 2021-07-06 |
| Last Update Date | 2025-03-31 |