NPI | 1285125724 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CT 78163) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 61080) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-05-21 |
Last Update Date | 2024-08-09 |