| NPI | 1023258969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV DO1468) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207L00000X Anesthesiology (Licence: TX N2499) | |
| Enumeration Date | 2009-03-05 |
| Last Update Date | 2015-09-24 |