| NPI | 1942794821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME154937) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IN 01083510A) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11020737A) | |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2023-09-05 |