NPI | 1417586652 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 011535) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-04-08 |
Last Update Date | 2025-07-17 |