| NPI | 1326466574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: NC 207LP2900X) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2016-00786) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2022-04-26 |