| NPI | 1629463294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MB11076300) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: PA OS020706) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2023-04-20 |