| NPI | 1477846459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 48040) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 48040) |
| 207LA0401X Anesthesiology, Addiction Medicine (Licence: KY 48040) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2024-02-13 |