| NPI | 1508094491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 259274) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 259274) |
| 207L00000X Anesthesiology (Licence: NY 259274) | |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2014-11-06 |