| NPI | 1851554927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: PA 50322) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD442783) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 50322) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2024-10-09 |