| NPI | 1831552942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV MD61139281) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207L00000X Anesthesiology (Licence: OR PG199400) | |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2021-08-14 |