| NPI | 1831693068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 166562) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CA 166562) | |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2026-08-07 |