| NPI | 1659699957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 253896) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 299152) |
| 207L00000X Anesthesiology (Licence: MA 253896) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MA 253896) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2023-07-03 |