| NPI | 1194014126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AL 52394) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX Q1976) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2026-04-24 |