| NPI | 1912584582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: PA MT223907) |
| Enumeration Date | 2021-03-28 |
| Last Update Date | 2025-06-18 |