| NPI | 1760008379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5151014243) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101027981) |
| Enumeration Date | 2020-06-19 |
| Last Update Date | 2024-05-16 |