| NPI | 1952197808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 10484) |
| Enumeration Date | 2025-04-17 |
| Last Update Date | 2026-03-24 |