| NPI | 1881155877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 011048) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 285433) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-31 |
| Last Update Date | 2024-05-10 |