| NPI | 1710290861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: AZ 63892) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 282721) |
| 207L00000X Anesthesiology (Licence: AZ 63892) | |
| 207R00000X Internal Medicine (Licence: MI 4301095954) | |
| 208M00000X Hospitalist (Licence: OH 120585) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301095954) | |
| Enumeration Date | 2010-07-19 |
| Last Update Date | 2021-07-21 |