| NPI | 1992061519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MN 61013) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 61013) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2020-08-25 |