| NPI | 1871857383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2022-00752) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A129183) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2022-10-20 |