| NPI | 1093132938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: LA 303114) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MS 26987) | |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2024-11-01 |