| NPI | 1881229730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MN 78968) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0102206742) |
| 208D00000X General Practice (Licence: VA 1881229730) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-10 |
| Last Update Date | 2025-04-06 |