| NPI | 1780061952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S8218) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2018-00938) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX S8218) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2024-02-28 |