| NPI | 1770993990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: HI 19717) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A142303) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: HI MDR-6659) | |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2019-06-03 |