| NPI | 1174985733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MN 70045) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CO DR.0064472) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2021-08-24 |