| NPI | 1548400088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 10438337-1204) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 005739) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-02-24 |
| Last Update Date | 2018-08-15 |