| NPI | 1730372368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: NC 2017-00315) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS41425) |
| 207L00000X Anesthesiology (Licence: SC 87524) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 191196) | |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2022-04-28 |