| NPI | 1447518881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 10158727-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 4078) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2024-03-26 |