| NPI | 1013477926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: MD D0101092) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: MD D0101092) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2024-07-26 |