| NPI | 1992948921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q0873) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207L00000X Anesthesiology (Licence: LA MD.206321) | |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2015-02-23 |