| NPI | 1861831620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD61074871) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: NE 28597) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2021-11-24 |