| NPI | 1215100193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 51609) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX p3101) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2024-04-17 |