| NPI | 1992902688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P5895) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2007018508) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2013-06-07 |