| NPI | 1316140965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: OR MD156934) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: WA MD60232145) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: OR MD156934) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2018-03-17 |