| NPI | 1407016827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P2373) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX P23713) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX 532469) | |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2020-10-30 |