| 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 |