| NPI | 1811283625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 008271) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA 20A12735) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2023-05-25 |