| NPI | 1932725546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 1027688) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MI 4301514699) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351046420) | |
| Enumeration Date | 2020-06-19 |
| Last Update Date | 2026-08-03 |