| NPI | 1700057395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 54543) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO DR.0052548) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-03-21 |
| Last Update Date | 2023-07-18 |