| NPI | 1932632569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME167249) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 64972) |
| 207L00000X Anesthesiology (Licence: TX T0181) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2024-04-11 |