| NPI | 1619395928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 83066) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 83066) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: GA 83066) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2023-08-17 |