NPI | 1417481664 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX T6545) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 32933) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-04-14 |
Last Update Date | 2022-06-10 |