| NPI | 1518278498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0101252995) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2012-11-29 |