| NPI | 1134651466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX U4209) |
| Additional Taxonomies | 246ZX2200X Specialist/Technologist, Other, Orthopedic Assistant |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP30067001) | |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2023-10-23 |