| NPI | 1427587294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX T7063) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NV 22937) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NV 22937) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10059844) | |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2023-08-07 |