| NPI | 1649628868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2021016590) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME145945) | |
| 207L00000X Anesthesiology (Licence: FL ME145945) | |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2022-07-05 |