| NPI | 1154883072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX V1722) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA 186037) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2026-10-29 |