| NPI | 1760903850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301506762) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2017022178) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2022-09-07 |