| NPI | 1730390709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q7170) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA MD.201887) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2019-12-19 |