| NPI | 1417299298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: OK 31587) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 31587) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2023-06-07 |