| NPI | 1780927814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA C190173) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35130989) |
| 207L00000X Anesthesiology (Licence: OH acknowledge letter) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2024-03-04 |