| NPI | 1073066247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: LA 322833) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA 322833) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2021-12-21 |