| NPI | 1649628868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME145945) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2021016590) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME145945) | |
| 207L00000X Anesthesiology (Licence: MO 2021016590) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2025-09-11 |