| NPI | 1134566946 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX R4649)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| 207L00000X Anesthesiology (Licence: TX R4649)  | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: TX R4649)  | |
| Enumeration Date | 2013-06-03 | 
| Last Update Date | 2024-03-27 |