| NPI | 1184155673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: TX U5980) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A158091) |
| 207P00000X Emergency Medicine (Licence: TX U5980) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-25 |
| Last Update Date | 2023-09-12 |