| NPI | 1770932717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A194497) |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2024-07-04 |