NPI | 1679836266 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: RI DO01082) |
Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: AZ 007285) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 252367) | |
Enumeration Date | 2012-06-19 |
Last Update Date | 2021-07-15 |