| NPI | 1588930242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 79983) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX Q8084) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX Q8084) | |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2026-07-16 |