| NPI | 1922532381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: NC 2022-01852) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 317695) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2025-06-01 |