| NPI | 1811522014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 1022233) |
| Enumeration Date | 2020-03-08 |
| Last Update Date | 2025-04-16 |