NPI | 1811487069 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 71202) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 326595) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-05-14 |
Last Update Date | 2024-01-18 |