| NPI | 1538513726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 87659) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL OS21459) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 87659) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 87659) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2025-08-11 |