| NPI | 1922323492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A135545) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD451510) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2019-12-09 |