| NPI | 1255868246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME149891) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A171992) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2022-08-24 |