| NPI | 1992383079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 1.084091-RES) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OS025624) |
| 207L00000X Anesthesiology (Licence: CT 82279) | |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2026-07-06 |