| NPI | 1730766700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A197733) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA 1730766700) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2025-08-11 |