| NPI | 1639518426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: IA MD-44932) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: IA R-10776) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2018-06-28 |