| NPI | 1114547239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX U8524) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10070502) |
| Enumeration Date | 2020-04-18 |
| Last Update Date | 2024-05-01 |