| NPI | 1710228226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0101256738) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101256738) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-07 |
| Last Update Date | 2023-02-21 |