| NPI | 1427553601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 13905851-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: DC MD210002066) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2025-05-15 |