| NPI | 1639602550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MB11649300) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: 63881) |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2023-10-16 |