| NPI | 1154883072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX V1722) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA 186037) | |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2024-06-20 |