| NPI | 1275882730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: ME MD21916) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: WA 60723587) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2023-10-02 |