| NPI | 1932633476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S6039) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: TX S6039) | |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2023-07-12 |