| NPI | 1194306266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 76428) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX V7616) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-04-19 |
| Last Update Date | 2025-05-07 |