NPI | 1316259575 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NV 16579) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL TRN15525) |
207LP2900X Anesthesiology, Pain Medicine (Licence: WI 63605-20) | |
390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 274356) | |
Enumeration Date | 2010-07-04 |
Last Update Date | 2018-09-13 |