| NPI | 1386943611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 8436562-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX U6870) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-03-25 |
| Last Update Date | 2023-11-20 |