| NPI | 1912439704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD477380) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD477380) |
| 207L00000X Anesthesiology (Licence: NJ 25MA11542800) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA11542800) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2022-12-06 |