| NPI | 1467867457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 81616) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 81616) |
| 207L00000X Anesthesiology (Licence: SC 91825) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN19789) | |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2024-04-16 |