| NPI | 1891139697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NM MD2018-0680) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2013-0488) |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2023-07-24 |