| NPI | 1710232772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX S0045) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 89035) |
| 207L00000X Anesthesiology (Licence: MI 4301100689) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 282377) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: ND 14409) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: ND 14409) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2023-01-18 |