| NPI | 1033672431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35.150539) |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2024-04-03 |