| NPI | 1316351091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: RI MD16703) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 259877) |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2019-05-16 |