| NPI | 1508226465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 20A18222) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA 20A18222) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-04 |
| Last Update Date | 2021-10-25 |