| NPI | 1427589399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 7222988-1204) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207L00000X Anesthesiology (Licence: OR DO223039) | |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2025-01-15 |