| NPI | 1003040056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 256841) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 256841) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-05-06 |
| Last Update Date | 2018-07-24 |