| NPI | 1902296239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MT MED-PHYS-LIC-129140) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA MD-55326) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2025-07-18 |