NPI | 1477901585 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 79215) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 310014) |
207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA11225000) | |
207LP2900X Anesthesiology, Pain Medicine (Licence: NY 310014-01) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-05-31 |
Last Update Date | 2024-09-04 |