| NPI | 1235330044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 41776) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX M4395) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2013-09-19 |