| NPI | 1437684891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: LA 330110) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: LA 330110) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2022-06-06 |