| NPI | 1558755736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: IL 036-158496) |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine (Licence: FL ME145781) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2022-12-21 |