| NPI | 1235454901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: ID O-0782) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ID O-0782) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: WA OP60530576) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-04-06 |
| Last Update Date | 2024-03-19 |