| NPI | 1568857878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A146332) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: CA A146332) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2021-02-27 |