| NPI | 1811288095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 77650) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN MD52428) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-22 |
| Last Update Date | 2022-10-05 |