NPI | 1588028401 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: LA 326272) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
208VP0000X Pain Medicine, Pain Medicine (Licence: LA 326272) | |
Enumeration Date | 2016-04-06 |
Last Update Date | 2021-06-15 |