| NPI | 1083867071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: UT 7154097-1204) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 63425) |
| 207L00000X Anesthesiology (Licence: UT 7154097-1204) | |
| Enumeration Date | 2008-11-04 |
| Last Update Date | 2023-08-07 |