| NPI | 1811215106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MT MED-PHYS-LIC-89802) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 49022) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2023-03-07 |