| NPI | 1003164989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: AZ 52943) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10036351) |
| 207L00000X Anesthesiology (Licence: MN 107187) | |
| 207L00000X Anesthesiology (Licence: AZ 52943) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-08-26 |
| Last Update Date | 2023-06-02 |