| NPI | 1881603967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA A61636) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A61636) |
| Enumeration Date | 2006-08-06 |
| Last Update Date | 2022-07-05 |