| NPI | 1225272842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 9701183-1205) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207L00000X Anesthesiology (Licence: NH 15303) | |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2016-08-26 |