| NPI | 1437594363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: NC 2022-00988) |
| Additional Taxonomies | 2083A0100X Preventive Medicine Aerospace Medicine (Licence: ND 13341) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2024-07-01 |