| NPI | 1538782545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0102206886) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0102206886) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-05-26 |
| Last Update Date | 2025-08-25 |