| NPI | 1962666180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q3922) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 46701) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2020-09-16 |