| NPI | 1922749985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WI 83064) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036180422) |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2026-07-31 |