| NPI | 1316309024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 310126) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 125075336) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2021-10-19 |