| NPI | 1780959973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: OR MD192339) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VT 042.0013624) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2019-06-03 |