| NPI | 1699398107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 73416) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207L00000X Anesthesiology (Licence: TX BP10072184) | |
| Enumeration Date | 2020-05-19 |
| Last Update Date | 2025-07-31 |