NPI | 1477088623 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX U2318) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2017-04-25 |
Last Update Date | 2024-07-02 |