| NPI | 1295178085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 287458) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CT 61926) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 287458) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: ZZ 01354) | |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2021-07-27 |