| NPI | 1932466588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: LA 310304) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 49185) |
| 207L00000X Anesthesiology (Licence: LA 310304) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: KY 49185) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2020-11-30 |