| NPI | 1023104445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: KS 04-34978) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2011008002) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2019-02-26 |