NPI | 1770978751 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 300225) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2015-04-06 |
Last Update Date | 2020-10-05 |