| NPI | 1750687356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 20A19632) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA 20A19632) | |
| 363A00000X Physician Assistant (Licence: CA PA21453) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-01-31 |
| Last Update Date | 2022-05-18 |