NPI | 1205320421 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MI 4301509226) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.253032) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301115069) | |
Enumeration Date | 2018-06-20 |
Last Update Date | 2023-09-13 |