| NPI | 1902463136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MA11922900) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: NJ 25MA11922900) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2024-06-09 |