| NPI | 1598984825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N-3575) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX N-3575) | |
| 207L00000X Anesthesiology (Licence: AR E-5861) | |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2009-11-18 |